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CERTIFICATION <br />The Applicant, Yuma Count (print applicant/company name), <br />by Howard McGinnis (print representative's name), as Truck and Mining Foreman (print <br />representative's title), does hereby certify that <br />Tyson Mann <br />(structure owner) shall <br />be compensated for any damage from the proposed mining operation to the above listed structure(s) <br />located on or within 200 feet of the proposed affected area described within Exhibit A, of the Reclamation <br />Permit Application for Moser Pit <br />File Number M -2008- 035 <br />(operation name), <br />This form has been approved by the Colorado Mined Land Reclamation Board pursuant to its <br />authority under the Colorado Land Reclamation Act for the Extraction of Construction Materials and <br />the Colorado Mined Land Reclamation Act far Hard Rock, Metal, and Designated Mining Operations. <br />Any alteration or modification to this form shall result in voiding this farm. <br />NO'T'ARY FOR PERMIT APPLICANT <br />ACKNOWLEGED BY: <br />Applicant Yams cl,('"F K,,kl Representative Name <br />Date 1 7 2 d i - Title %/i'uciC' X%rdc1 %Yl rU aRCn >��yl/ <br />STATE OF <br />`I ) <br />COUNTY OF �l u SS. m 0, ) <br />1 The foregoing was acknowledged before the this 11 day of c�-r`�^, 205 <br />5, by <br />woc 3 d <br />My Commission. Expires: <br />Nothry Publi <br />U 3 1�ak�, <br />ETA <br />LIE <br />